Faster Cancer Treatment

Faster cancer treatment indicators were introduced in July 2012, requiring district health boards to collect standardised information on patients who had been referred urgently with a high suspicion of cancer.

31 day indicator – patients with a confirmed cancer diagnosis receive their first cancer treatment (or other management) within 31 days of a decision to treat

62 day indicator – patients referred urgently with a high suspicion of cancer receive their first treatment (or other management) within 62 days of the referral being received by the hospital

DHBs also began reporting on the Shorter waits for cancer treatment health target in July 2012, which required that all patients who are ready for treatment should wait less than four weeks for radiotherapy or chemotherapy. The Shorter waits for cancer treatment health target was consistently achieved for all patients in all DHBs and from October 1 2014 was replaced by the new 62-day cancer target based on the previous 62-day indicator.

What is the Faster cancer treatment 62-day target?

The new target covers patients referred when there is a high suspicion of cancer and the hospital doctor receiving the referral believes there is a need for an appointment within two weeks.

DHBs are expected to meet the target for 85 percent of patients by July 2016 and for 90 percent of patients by June 2017.

Why do we need a cancer target?

Health targets provide a focus on areas that are a significant priority for the public and the government. Achieving national targets can be challenging, but evidence from New Zealand and overseas confirms that they have an important role in speeding up and extending access to services and in driving positive change.

Prompt investigation, diagnosis and treatment is more likely to ensure better outcomes for patients, and an assurance about the length of waiting time can reduce the stress on patients and families at a difficult time.

What is the definition of first cancer treatment?

First cancer treatment is the first treatment a person receives for their cancer and includes surgery, radiation treatment, chemotherapy, targeted therapy, non-intervention management such as active surveillance, and palliative care.

Why was the target changed?

The new target has a broader focus, covering all tests and investigations needed to confirm a diagnosis before an agreed course of treatment commences and all forms of treatment, including surgery and palliative care.

It allows us for the first time to monitor the whole pathway for a cancer patient, from being referred as an outpatient to receiving treatment. It provides DHBs, cancer networks and the Ministry of Health with additional learning and incentive for further improvement.

Although the target focuses on a particular cohort of patients, improvements in access and quality of care can benefit all cancer patients.

How will the new target help improve access to treatment?

The new target allows hospitals to improve integration and information-sharing and to identify any bottlenecks in the system by tracking the whole experience for cancer patients, from being referred through the full range of investigations and treatment.

Reporting against the target enables hospitals to focus available resources on areas of greatest need along the whole patient pathway. The information collected can also inform wider decisions on investment in facilities and workforce development.

Where did the 62-day timeframe come from?

The 62-day timeframe is based on measures used internationally in both the UK and Canada. A 62-day cancer treatment target was introduced in the UK in 2001 and the number of patients receiving their first treatment in the target period rose from approximately 60 percent to over 85 percent.

How come it can take two months for treatment to begin if somebody is referred urgently?

62 days is the timeframe set for treatment to begin, but in many cases patients will start treatment sooner. Within the two-month period a range of tests are likely to be carried out to confirm the diagnosis and to agree on treatment options. The case is likely to be discussed at a multidisciplinary meeting which brings together a range of health professionals from different specialties to agree on the best course of treatment.

Why is the target not set at 100 per cent?

For the 62-day cancer target DHBs report on waiting times for adult patients (aged over 16) who meet the criteria. A small proportion of patients will not need to begin treatment within 62-days based on clinical evidence of what is most effective – for example, if further investigations are needed, or if the patient developed an infection before scheduled surgery. A small number of patients may also choose to delay treatment because of personal circumstances.

What happens if a hospital doesn’t meet the target?

DHBs will report against the new target as they already do with other health targets and the data will be publicly reported each quarter. This public reporting ensures accountability to patients and the public as well as the Government and is an incentive for continued improvement in performance.

How does the target apply if a patient is treated in more than one DHB?

The DHB where a patient normally lives is responsible for reporting on their progress. If treatment takes place within another DHB, information needs to be shared between organisations to ensure effective monitoring. DHBs will be expected to focus on improving information sharing and gathering good quality data over the next two years.

What other cancer measures do DHBs report on?

DHBs continue to report on the 31-day ‘decision to treat to treatment’ indicator, which is designed to support further progress in improving access to treatment for all cancer patients.

They will report on the waiting times for diagnostic and surveillance for particular investigations such as colonoscopies and endoscopies.

DHBs will also report on their progress to improve the coverage and functionality of multidisciplinary meetings.